Halaman 1

RENCANA KEBUTUHAN OBAT DAN PERBEKALAN KESEHATAN TAHUN 2021

PUSKESMAS : BIRAYANG
KABUPATEN / KOTA : HULU SUNGAI TENGAH

Pemakaian
Rata-Rata
Per Bulan
JUMLAH
SISA STOCK
(Jumlah Pemakain KEBUTUHA
NO. NAMA OBAT SATUAN HARGA 30 Agustus TOTAL HARGA KETERANGAN
Jan-Agustus 2020 N (18
2020
tidak termasuk jumlah BULAN)
obat yang ed dibagi 8)

1 2 3 4 5 6 8 9
47 Diazepam injeksi 5 mg/ml - 2 ml AMPUL 1,913 1 4 24 38,260
64 Fenobarbital injeksi 50 mg/ml - 2 ml AMPUL 2,265 - - 6 11,325
69 Fenol gliseron tetes telinga 10 % BTL 2,764 5 35 120 276,400
71 Fitomenadion (vit.k1) tablet salut 10 mg TAB 873 11 100 240 174,600
73 Furosemida tablet 40 mg TAB 84 21 335 120 8,400
76 Garam oralit untuk 200 ml air BKS 281 40 300 1,200 281,000
77 Gentian violet larutan 1 % BTL 2,999.7 3 31 18 44,996
78 Glass Ionomer Cement ( gc ix )FUJI IX ART MP 10 G KTK 833,100 0 1 1 833,100
79 Glibenklamida tablet TAB 137.00 10 450 240 27,400
80 GUAIFENESIN 100 MG TABLET TAB 147.99 75 607 1,800 221,985
82 Glukosa larutan infus 10 % steril BTL 7,500 4 - 24 150,000
83 Glukosa larutan infus 40 % steril @ 25 ML BTL 8,999.98 - - 12 90,000
84 Glukosa larutan infus 5 % steril BTL 7,363 45 191 1,200 7,363,000
87 Haloperidol tablet 1,5 mg TAB 59 113 735 2,400 118,000
90 Hidrokortison krim 2,5 % TUBE 2,533 10 34 300 633,250
91 Ibuprofen tablet 200 mg TAB 358 336 470 1,200 358,000
92 Ibuprofen tablet 400 mg TAB 288 40 50 1,200 288,000
94 Infusion set anak SET 7,072.5 1 75 120 707,250
95 Infusion set dewasa SET 6,670.0 60 179 1,800 10,005,000
100 Isosorbid dinitrat tablet sublungual 5 mg TAB 152.46 - - 480 60,984
104 Kalsiumlaktat (kalk) tablet 500 mg TAB 63 351 1,065 8,400 441,000
106 Karbamazepin tablet 200 mg TAB 227.27 33 210 960 181,816
107 Kasa pembalut 4 cm x 10 cm ROL 1,725 8 108 180 258,750
109 Kasa pembalut 16 cm x 16 cm KOTAK 9,200 1 71 480 3,680,000
110 Kasa kompres 40/40 steril BKS 1,840 10 120 120 184,000
111 Kasa pembalut 2 m x 80 cm BKS 8,855 0 30 12 88,550
112 Kasa pembalut hidrofil 4 m x 15 cm BKS 2,415 2 100 42 84,525
113 Kasa pembalut hidrofil 4 m x 3 cm BKS 678.5 2 44 48 27,140
115 Kloramfenikol salep mata 1 % TUBE 1,850 7 7 120 185,000
117 Klorfeniramina maleat (ctm) tablet 4 mg TAB 60.96 540 530 12,000 609,600
121 Klorpromazina hcl tablet salut 100 mg TAB 170 80 1,035 840 119,000
123 Kertas ECG uk. 80 MM X 20 M ROL 96,150 - - 4 288,450
124 Kodeina hcl (kodeina) tablet 10 mg TAB 657 52 184 1,200 657,000
125 KACAMATA GOGGLE SEKAR GUNA M PCS 200,000 - - 6 1,000,000
127 Kotrimoksazol suspensi BTL 2,190 9 15 120 219,000
128 Kotrimoksazol dewasa tablet, TAB 125 13 400 360 37,500
129 LODECON TABLET TAB 480.37 1 490 6,000 2,401,850
130 LODECON FORTE TABLET TAB 607.42 61 950 1,200 607,420
136 L-BIO BKS 6,930 - - 120 693,000
139 Lidokaina com.injeksi.kombinasi AMPUL 1,317 40 160 1,200 1,317,000
146 Metilergometrina maleat tablet salut 0,125 mg TAB 259.0 19 150 120 25,900
147 Metilergometrina maleat inj. 0,200 mg/ml - 1 ml AMPUL 3,399 1 23 18 50,985
152 MEYLON 8,4% @ 25 ML BTL 6,448 0 2 2 12,896
153 Natrium klorida larutan infus 0,9 % steril BTL 6,840 18 87 840 4,788,000
155 Nistatin 100.000 iu/g tablet vagina TAB 645 - - 24 12,900
156 Nistatin 500.000 iu/g tablet salut TAB 857 - - 24 17,140
160 Obat batuk hitam ( O B H ) cairan BTL 10,725 0 48 60 536,250
163 Oksitetrasiklina hcl salep mata 1 % TUBE 2,774 7 59 120 277,400
164 Oksitosina injeksi 10 iu/ml - 1 ml AMPUL 1,232 46 481 18 18,480
166 Parasetamol sirup 120 mg/5 ml BTL 5,041.0 3 215 1,200 5,041,000
168 Parasetamol tablet 500 mg TAB 195.00 2,802 6,712 60,000 9,750,000
169 Parasetamol drop BOTOL 7,646 15 21 300 1,911,500
176 Piridoksina hcl (vit.b6) tablet 10 mg TAB 150 287 1,220 6,000 750,000
178 Prednison tablet 5 mg TAB 79 102 1,020 3,000 197,500
181 Propiltiourasil tablet 100 mg TAB 733.54 - - 360 220,062
183 Rapid Test Covid Igg-Igm Lungene PCS 167,200 - - 30 4,180,000
185 Retinol ( Vit A )tablet salut 200.000 IU TAB 637.0 222 - 12 6,370
189 Ringer Laktat Larutan Infus Steril BTL 7,630 128 239 3,000 19,075,000
191 Salbutamol tablet 4 mg TAB 77 61 615 1,200 77,000
193 Salisil Bedak 2 % KTK 1,066.000 7 5 156 138,580
194 SARUNG TANGAN NON STERIL S PCS 880 - - 600 440,000
196 Serum Anti Bisa Ular Polivalen Inj 5 ml (ABU I ) AMPUL 512,204 0 2 6 2,561,020
197 Serum anti tetanus inj.1.500 iu/ampul (a.t.s) AMPUL 130,999 0 8 7 785,994
205 SARUNG TANGAN NITRILE L PCS 990 - - 240 198,000
206 Sulfasetamida tetes mata 15 % BTL 8,800 1 - 6 44,000
208 Tablet Tambah Darah Kombinasi TAB 409 273 2,110 8,400 2,863,000
210 THERMOMETER FORHEAD OMRON PCS 419,950 - - 2 839,900
 Halaman 2

Pemakaian
Rata-Rata
Per Bulan
JUMLAH
SISA STOCK
(Jumlah Pemakain KEBUTUHA
NO. NAMA OBAT SATUAN HARGA 30 Agustus TOTAL HARGA KETERANGAN
Jan-Agustus 2020 N (18
2020
tidak termasuk jumlah BULAN)
obat yang ed dibagi 8)

1 2 3 4 5 6 8 9
214 Thiamin hcl/mononitrat (vit b1) tablet 50 mg TAB 94 1,048 3,644 21,600 1,692,000
215 Triheksifenidil Hidroklorida tablet 2 mg TAB 95 77 640 1,800 142,500
216 Trikresol formalin (tkf) cairan BTL 80,800 - - 2 161,600
217 Vaksin rabies Vero KUUR 139,150 1 - 10 1,113,200
218 Vitamin B komplek tablet TAB 135 993 1,995 18,000 2,025,000
219 Yodium Povidon larutan 10 % 300 ml BTL 21,600 1 7 12 216,000
220 Yodium Povidon larutan 10 % 30 ml BTL 3,840 0 9 12 38,400
222 AUTOCLICK (Lancet devide) SET 20,028.42 - 1 5 80,114
223 ALAT CEK HB Mission Acon PCS 765,000 - - 2 1,530,000
224 ALAT SUNTIK 3 ML PCS 750.3843 213 923 9,000 5,627,882
228 ALPRAZOLAM TAB 1 mg TAB 120 24 18 600 60,000
230 AMBROXOL SIRUP BTL 6,270 1 149 600 3,135,000
231 AMBROXOL TABLET TAB 313.5 99 1,366 12,000 3,135,000
232 AMLODIPINE 10 MG TAB 94 305 1,960 9,000 705,000
233 AMLODIPINE 5 MG TAB 243 1,047 1,551 24,000 4,860,000
235 AMOKSISILLIN KAPLET 500 MG TAB 248 1,285 3,799 12,000 2,480,000
238 ANTASID SUSPENSI BTL 2,239 56 6 1,800 3,358,500
239 ANTRAIN/NORAGES INJEKSI/METAMIZOLE INJ AMPUL 8,266.5 33 149 1,200 8,266,500
240 APD COVERALL SUIT BOHO PCS 1 - - 12 10
242 ARSUAMOON TABLET (DHP/ANTI MALAR) KTK 19,206 - - 12 192,060
243 ACETYLCYSTEINE 200 MG KAPSUL 440 - - 12,000 4,400,000
253 ASAM MEFENAMAT KAPLET 500 MG TAB 259.56 1,149 2,056 30,000 6,489,000
254 ASEPTAN ANTISEPTIK BOTOL 30,475 3 5 72 1,828,500
255 ASICLOVIR SALEP TUBE 3,465 3 4 120 346,500
256 ASICLOVIR TABLET 200 mg TAB 272 21 129 360 81,600
257 ASICLOVIR TABLET 400 mg TAB 425 60 623 1,800 637,500
258 ATTAPULGIT TABLET TAB 187 - 100 120 18,700
259 BUDESONIDE 0.25 MG/ML(PULMICORT RESPULES PCS 9,725 7 20 120 972,500
260 AZITROMISIN 500 MG TAB KAP 4,613 - - 360 1,383,900
261 BAHAN TAMBAL GIGI CAVITON (CAVIT W DAN P KOTAK 245,000 0 2 1 245,000
265 BECEFORT KAPLET TAB 1,826.0 68 - 1,800 2,739,000
266 BIOLYSIN SYRUP BTL 11,495 10 - 1,200 11,495,000
268 BEROTEC 0.1% LARUTAN 50 ML BTL 130,190 0 - 6 650,950
269 BETAHISTIN TABLET 6 MG TAB 119 100 700 2,400 238,000
270 BLOOD TRANSFUSION SET SET 6,195.2 3 39 12 61,952
271 NEUROBION INJEKSI AMPUL 3,190 - - 360 957,000
272 BENEORON TABLET (BIORON) TAB 711.5 - - 3,000 1,778,750
274 BABY COUGH SIRUP BTL 4,500 - - 36 135,000
275 BISAKODIL TAB TAB 316 - - 12 3,160
276 BISOPROLOL 5 MG TABLET TAB 399 - - 120 39,900
277 BISTURI NO 15 (aesculap 15) PCS 3,069 10 - 240 613,800
278 BLOOD LANSET SET 161.00 278 400 4,800 644,000
286 CAPTOPIL TABLET 12,5 MG TAB 69 5 - 840 48,300
287 CAPTOPRIL TABLET 25 MG TAB 72.73 64 - 1,800 109,095
289 CATGUT PLAIN 2/0 PCS 5,750 3 72 30 143,750
291 CEFIXIM 100 KAPS TAB 2,430 - - 1,200 2,430,000
292 CEFIXIM SYR BTL 9,400 - - 24 188,000
293 CEFOTAXIM 1 g INJEKSI VIAL 4,706 36 95 840 3,294,200
295 CEFTRIAXON INJEKSI VIAL 5,146.0 10 20 240 1,029,200
298 CENDO XITROL BTL 27,500 - - 12 275,000
299 CEPADROXYL KAPSUL KAP 650.000 94 1,100 12,000 6,500,000
300 CEPADROXYL SYR 125MG/5 ML BTL 4,360 2 1 60 218,000
301 CETIRIZIN SYRUP BTL 3,061 10 - 600 1,530,500
302 CETIRIZIN TABLET TAB 104 157 100 18,000 1,560,000
305 CLINDAMYCIN KAP 150 MG KAP 803.00 78 208 1,560 1,043,900
309 CLOBETAZOL KRIM 0,05%(LOTASBAT KRIM) TUBE 66,000 0 - 6 330,000
311 CROFED TAB 1,430 - - 360 429,000
319 CURCUMA (SARI TEMULAWAK) TAB 876.15 112 736 4,800 3,504,600
321 CYPROFLOXACIN TABLET TAB 650 28 - 9,000 4,875,000
322 D5% 1/4NS BTL 9,350 1 - 24 187,000
323 DIAPERS OTO ADULT M10 PCS 5,500 2 49 48 220,000
324 DIAPERS OTO ADULT L 8 PCS 6,875 2 72 36 206,250
325 DIAPERS OTO ADULT XL 6 PCS 9,166.70 1 30 12 91,667
327 DEXTROFEN SYRUP BOTOL 13,200.00 - - 60 660,000
331 DOMPERIDON 10 MG TAB TAB 90 72 30 1,560 117,000
332 DOMPERIDON SIRUP BTL 2,862 1 - 60 143,100
333 DOXYCICLIN KAPSUL TAB 264 - - 120 26,400
337 EKG 6 CM UNTUK MESIN ECG ROLL 193,600 0 - 6 968,000
346 FDC I PAKET 477,791 2 5 1 477,791
353 FRESH CARE( MINYAK ANGIN) BTL 15,700 - - 18 235,500
354 FLUOSINOLON cream SYNARCIS TUBE 2,660 2 10 12 26,600
356 FOLEYCATH No. 16 2 way SET 18,271.0 1 9 24 365,420
357 FOLEYCATH No. 18 SET 18,271 2 10 48 730,840
362 GLUCOSAMINE 500 MG KAPLET 3,402.7 - - 360 1,020,810
 Halaman 3

Pemakaian
Rata-Rata
Per Bulan
JUMLAH
SISA STOCK
(Jumlah Pemakain KEBUTUHA
NO. NAMA OBAT SATUAN HARGA 30 Agustus TOTAL HARGA KETERANGAN
Jan-Agustus 2020 N (18
2020
tidak termasuk jumlah BULAN)
obat yang ed dibagi 8)

1 2 3 4 5 6 8 9
363 GELAS UKUR 100 ML PCS 116,600 - - 1 116,600
367 GENTAMICIN SALEP KULIT TUBE 1,980 1 - 240 396,000
368 GENTAMICIN SALEP MATA 0.3% ( genion) TUBE 2,950 4 - 120 295,000
369 GENTAMICIN TETES MATA BTL 4,885 - - 30 122,125
371 GLIMEPIRIDE 2 MG TAB 207 93 225 1,800 310,500
376 H2O2 3% BTL 4,032 0 5 2 8,064
378 HAND SCOON NO 6,5 STERIL PCS 10,460.51 17 65 240 2,092,102
379 HANDSCOON NON STERIL ukuran M,KPP PCS 935.00 349 - 18,000 14,025,000
380 HEMAFORT TABLET TAB 853.88 39 - 3,600 2,561,640
386 HYSCOPAN/ SCOPMA TABLET TAB 330 - - 360 99,000
391 IBUPROFEN 200 MG SYR/ 5 ML BTL 5,414 2 36 48 216,560
392 IHTIOL SALEP TAB 5,500 - 24 6 27,500
393 ILIADIN DROP 0.025% TTS HIDUNG ANAK BTL 37,433 2 - 6 187,165
395 ILIADIN SPRAY 0.050% TTS HIDUNG DEWASA BTL 39,468 1 - 24 789,360
397 JELLY EKG BOTOL 22,411.2 - 2 12 224,112
399 KA. DIKLOFENAK 50 MG TAB 770 - - 2,400 1,540,000
400 KALNEX KAPSUL/ ASAM TRANEKSAMAT TAB 1,784 65 - 840 1,248,800
401 KANTONG PLASTIK BKS 2,970 3 - 120 297,000
402 KAPAS BERALKOHOL (ALKOHOL SWABS) PCS 138.0 200 400 3,000 345,000
403 KERTAS PUYER MESIN PAK 150,000 - - 12 1,500,000
405 KASA HIDROFIL 40 x 80 CM ROL 155,250 1 8 24 3,105,000
406 KERTAS PUYER LIPAT PAK 20,000 - - 1 20,000
407 KETOKONAZOL 2% CREAM TUBE 2,577 9 48 120 257,700
408 KETOKONAZOL TAB TAB 305 1 80 120 30,500
409 KETOPROPEN 100 TAB TAB 553 - - 60 27,636
411 KETOROLAC 30 MG/1 ML INJ AMPUL 1,045.00 - - 6 5,225
415 KOMPOLAX SYRUP 60ML BTL 5,687 3 6 90 426,525
419 LANZOPRAZOL TAB TAB 330 3 - 1,200 330,000
425 LORATADIN TABLET 10 MG TAB 136 82 453 1,800 204,000
427 MASKER N95 PCS 65,000.0 11 80 240 13,000,000
428 MASKER BEDAH (VICA CHECK), MMP,KPP,SST PCS 3,204.828 195 - 48,000 128,193,120
430 MB DEWASA BLISTER 36,579 0 6 1 36,579
431 MINDRAY DILUENT 20L GALON 1,730,300 - - 2 3,460,600
432 MELOKSIKAM 15 MG TAB TAB 1,366.86 72 - 3,600 4,100,580
433 MELOXICAM 7,5 MG TAB TAB 788.766 151 90 9,600 6,310,128
434 MINDRAY M-30 CFL LYSE 500 ML BOTOL 1,996,500 - - 2 3,993,000
436 MINDRAY M-30 PROBE CLEANSER 17 BOTOL 332,750 - - 2 665,500
437 METFORMIN 500 MG TABLET TAB 109 209 60 24,000 2,180,000
438 MORTIR NO.16 PCS 100,100 0 - 2 200,200
440 MASKER KN 95 PCS 71,250 - - 24 1,425,000
441 METILPREDNISOLON 4 MG TABLET TAB 148 450 1,671 24,000 2,960,000
443 METOCHLORPROPAMIDE 10 MG TABLET TAB 89 2 90 120 8,900
446 METRONIDAZOL 500 MG TAB TAB 261.7 33 490 840 183,190
447 METRONIDAZOLE SYRUP BOTOL 3,950 1 22 24 79,000
449 MICONAZOL 2% KRIM TUBE 3,926 9 61 180 588,900
452 MINI ASPI 80 MG TABLET 105.00 33.7777777777778 225 1,200 105,000
454 MINDRAY RINSE M30 20L GALON 1,730,300 - - 2 3,460,600
455 NATRIUM DIKLOFENAK TAB 25 MG TAB 152 542 725 9,000
456 NATRIUM DIKLOFENAK TAB 50 MG TAB 136 342 - 1,200 136,000
459 NEEDLE NO 24 G SET 311 50 142 240 62,200
460 NEEDLE NO 25 G SET 311.00 8 126 900 233,250
462 NASAL CANULA CHILD SET 6,325 1 30 24 126,500
463 NASAL CANULA ADULT SET 6,325 2 11 30 158,125
466 NIFEDIPIN TABLET 10 MG TAB 110 26 - 240 22,000
467 NISTATIN DROP (KANDISTATIN DROP) BOTOL 45,100 - - 84 3,157,000
470 NOZA TAB TAB 935.0 79 - 600 467,500
471 O A T KATEGORI ANAK (fdc Anak) KTK 285,343 0 2 2 570,686
473 OXYGEN MASK CHILD SET 15,584.8 0 15 14 187,018
476 OMEPRAZOL TAB 147 1,283 3,345 24,000 2,940,000
477 OMEPRAZOLE INJEKSI AMP 11,868 1 80 600 5,934,000
478 ONDANSETRON 8 MG TAB TAB 404 44 - 720 242,400
479 OXYGEN MASK ADULT SET 15,584.8 0 9 6 77,924
480 PANTOCAIN TTM 0,5 % BTL 11,500 - - 12 115,000
484 RAPID TEST COVID 19 WONDFO PROVINSI PCS 1 - - 30 25
488 PREMILINE 2/0 PCS 54,600.00 - - 120 5,460,000
489 PREMILINE 3/0 (19,24) PCS 54,600.00 2 - 300 13,650,000
495 PENJEPIT TALI PUSAT PCS 3,025 7 145 180 453,750
496 PHARMAFIX 10 X 500 CM (FIXOMULL) ROLL 90,000 1 6 60 4,500,000
507 PLASTIK KLIP OBAT BESAR (13CMX8,7CM) BKS 6,000 0 23 12 60,000
508 PLASTIK KLIP OBAT KECIL (10CMX7CM) BKS 3,600 0 23 4 10,800
509 PLASTIK KLIP OBAT TANGGUNG (12CMX8CM) BKS 4,800 1 18 12 48,000
514 RANITIDIN INJEKSI 25 mg/ml AMPUL 1,155 44 - 2,400 2,310,000
526 ROLL PAPER ELECTROCARDIO 8 CM ECG -300 ROL 92,560 0 1 6 462,800
528 RECO TETES MATA (KLORAMFENIKOL) BTL 8,250.0 1 21 180 1,237,500
 Halaman 4

Pemakaian
Rata-Rata
Per Bulan
JUMLAH
SISA STOCK
(Jumlah Pemakain KEBUTUHA
NO. NAMA OBAT SATUAN HARGA 30 Agustus TOTAL HARGA KETERANGAN
Jan-Agustus 2020 N (18
2020
tidak termasuk jumlah BULAN)
obat yang ed dibagi 8)

1 2 3 4 5 6 8 9
529 RECO TETES TELINGA (KLORAMFENIKOL 1%) BTL 8,250.0 1 25 180 1,237,500
541 REAGEN XYLOL BTL 23,100 0 - 6 115,500
542 RETINOL ( Vit A )tablet salut 100.000 IU TAB 356 39 - 120 35,600
548 STIMUNO FORTE TABLET TAB 2,351.25 1,232 - 600 1,175,625
549 SCABIMITE ( Permethrin 5%) TUBE 11,825 0 16 60 591,250
551 SERUM GOL DARAH ANTI A BTL 73,500.00 - 2 6 367,500
552 SERUM GOL DARAH ANTI B BTL 73,500.00 - 2 6 367,500
555 SAFETY BOX 5 L PCS 16,501.00 3 24 120 1,650,100
556 SIMVASTATIN 10 mg TAB 113 52 - 2,400 226,000
557 SIMVASTATIN 20 MG TAB TAB 237 140 30 4,800 948,000
559 SO KLIN PEMUTIH (BAYCLIN) BTL 10,670 1 - 36 320,100
560 SARUNG TANGAN OBGYN STERIL PSNG 21,850 11 180 180 3,277,500
561 SABUN ANTI BAKTERI BTL 30,360.00 2 15 36 910,800
563 SPIRITUS 85 % BTL 39,999.96 0 1 1 40,000
564 SPIRONOLAKTON 25 MG TAB TAB 226 18 200 120 22,600
565 SOLAFLUZ SIRUP BTL 15,246 - 20 240 3,049,200
566 SANGOBION DROP BOTOL 37,290 - - 6 186,450
569 STESOLID RECTAL TUBE 10 MG TUBE 21,021 1 5 12 210,210
570 STESOLID RECTAL TUBE 5 MG TUBE 14,459 0 5 12 144,590
571 STIK ASAM URAT BENECHEK KOTAK 170,163.16 3 12 60 8,508,158
573 SELKOM-C TAB 1,347.50 321 - 18,000 20,212,500
574 STIK GULA DARAH BENECHEK KOTAK 155,675 4 20 60 7,783,750
575 SOLVITRAL TABLET 563.86 634 310 18,000 8,457,900
577 STIK KOLESTEROL AUTOCHEK KOTAK 423,775 1 7 18 6,356,625
578 STIK HIV TEST (SD BIOLINE HIV) PCS 28,667 11 - 24 573,340
579 STIK RPR SYPILIS STRIP 4,260 3 - 12 42,600
580 STIK HAEMOGLOBIN Mission ACON KOTAK 408,571.43 - 8 12 4,085,714
582 STIK KOLESTEROL BENECHEK KOTAK 256,122 8 - 120 25,612,200
584 SARUNG TANGAN NON STERIL UK.L PCS 935 - - 120 93,500
585 STOMAG TUBE NO 12 SET 4,081 - 12 4 12,243
586 SURFLO 26 PCS 12,000 - - 60 600,000
587 SURFLO NO 18 G SET 6,270 6 81 120 627,000
588 SURFLO NO 20 G SET 6,270 42 141 900 4,702,500
589 SURFLO NO 22 G SET 6,270 43 105 1,200 6,270,000
590 SURFLO NO 24 G SET 6,270 13 136 360 1,881,000
592 SURGICAL GLOVES STERIL 7,5 REMEDI,MAX PSNG 10,460.51 38 - 840 7,322,357
593 TABUNG EDTA K3 (VACUUM TUBE STERIL) PCS 1,405 33 100 600 702,500
599 TERMOHIGROMETER SET 353,100 - - 1 353,100
600 TERBUTALIN (BRICASMA) RESPULES PCS 7,124 2 - 18 106,860
605 TES KEHAMILAN SET 2,185.00 16 139 360 655,500
610 PHARMAFIX 10 CM X 10 M PCS 77,039.6 - - 6 385,198
611 URIN BAG PCS 5,904.8 6 22 84 413,336
612 VAR ( Vaksin Anti Rabies ) AMP 165,000 1 8 19 2,640,000
613 VENTOLIN NEBULIZER BTL 4,000 - - 60 200,000
614 VITAMIN B 12 TABLET TAB 52 101 1,190 2,400 104,000
615 WATER ONE 1 LITER BTL 17,952 0 - 1 17,952
617 WING NEEDLE NO 25 SET 1,610 13 - 30 40,250
619 YODIUM POVIDON 60 ML BTL 5,412 1 10 6 27,060
622 ZINC SYRUP 20 MG (ZIRCUM KID) BTL 3,285 1 44 120 328,500
623 ZINC TABLET TAB 604 169 450 3,240 1,630,800
624 ASAM TRANEKSAMAT INJ AMP 2,225 4 10 12 22,250
625 AESCULAP NO.20 PCS 3,069 - 100 120 306,900
626 BAYI OXYFLOW PCS 6,325 0 9 6 31,625
627 D 1/4 NS INFUS BOTOL 10,624 2 - 24 212,480
628 KA-EN 3B INFUS BTL 10,050 1 - 6 50,250
629 SUKRALFATE SUSPENSI BOTOL 7,338 - - 600 3,669,000
632 CATGUT PLAIN 4/0 PCS 33,855 0 - 60 1,692,750
633 MY JELLY KOTAK 33,982.3 1 5 4 101,947
634 ONDANSETRON 4 MG TAB TAB 429 120.222222222222 313 2,400 858,000
635 SALBUTAMOL SYRUP 2 mg/5 ml BOTOL 4,446 0.555555555555556 - 6 22,230
636 METRONIDAZOLE OVULA/ VAGISOL OVULA 3,590 3.44444444444444 (1) 36 107,700
637 ALOPURINOL 300 MG TAB TAB 216 33 - 1,800 324,000
639 CENDO LYTHER BTL 19,125 - - 36 573,750
640 ALAT LABORATORIUM BENECHEK BUAH 222,682 - - 2 445,364
641 KLORAMFENIKOL 500 MG (CLORAMEX) KAP KAPSUL 1,338 22 - 60 66,900
643 DOMPERIDON DROP BOTOL 26,240 1 - 24 524,800
648 CAT GUT PLAIN3/0 SET 5,750.0 9 43 60 287,500
653 ZEIHL NEELSEN (INDO Reagent))INDOTEC KOTAK 417,900 - 5 4 1,253,700
656 SARUNG TANGAN NON STERIL UK.S SET 657.8 - - 6,000 3,289,000
660 RAPID TEST HBSAg ( VIRO CHECK) PCS 8,233 - 45 120 823,300
661 BISTURI/ AESCULAP NO 10 PCS 3,300 9 100 120 330,000
663 ONDANSETRON HCL DIHYDRATE 4 MG INJ AMPUL 1,258 11 54 960 1,006,400
665 KACA SLIDE NO.7101 KOTAK 20,244.78 - 3 2 40,490
668 KAPAS 500 MG BKS 31,372 1 9 6 156,860
 Halaman 5

Pemakaian
Rata-Rata
Per Bulan
JUMLAH
SISA STOCK
(Jumlah Pemakain KEBUTUHA
NO. NAMA OBAT SATUAN HARGA 30 Agustus TOTAL HARGA KETERANGAN
Jan-Agustus 2020 N (18
2020
tidak termasuk jumlah BULAN)
obat yang ed dibagi 8)

1 2 3 4 5 6 8 9
669 KAPAS BERALKOHOL AC. SWAB PCS 178.250 33 600 1,200 178,250
670 SURGICAL GLOVES STERIL NO.7 (Mxter, Sfe glves,KPP) PSNG 10,460.51 14 - 360 3,138,153
671 UNDERPAD STERIL 60X90 CM PCS 8,769.90 9 26 60 438,495
672 UNDERPAD NON STERIL 60X90 CM PCS 4,786.76 2 20 180 718,014
673 ULTRASONIC GEL 250 ML BOTOL 15,100.8 1 - 12 151,008
676 ZINC PRO DROPS 10MG BOTOL 6,281 4 5 84 439,670
677 PHYTOMENADION INJ 2 MG/ML AMPUL 4,236 23 66 96 338,880
678 ATRAMAT POLYPROPYLENE 4-0 SET 28,895.5 10 - 240 5,779,100
679 SULFADIAZINE SILVER SAL KUL GENERIK TUBE 20,700 0 - 24 414,000
681 SARUNG TANGAN MAXTER EXAM NON POWDER M PCS 648 - - 10,800 5,832,000
688 ASAM FOLAT TABLET 0.4 MG(PROFOLAT) TABLET 64 12 215 240 12,800
691 PHENOBARBITAL INJ.50MG/ML-1ML AMPUL 2,265 2 10 6 11,325
700 SCOPMA PLUS KAPLET 1,155 1 - 600 577,500
701 THIAMEX (THIAMFENICOL 500 MG) KAPSUL 660 26 - 120 66,000
708 ARFEN TABLET 460.0 18 380 600 230,000
230,000
BATAS LAPORAN SEPTEMER 2020

TAMBAHAN LAINNYA jlh satuan / kemasan

1 CHKM (Chlorofenol Champor menthol) 2 botol
2 Setoject (jarum) 100 pcs
3 Carpule 100 pcs
4 Setoject 3 pcs
5 GUEDEL / AIR WAY 20 pcs
6 Kertas EKG ukuran lebar 80 mm x 20 20 pcs
7 TKF 2 box
8 Antisera Golongan Darah / Reagen Golongan Darah 6 set
9 Reagen Rinse 2 set
10 Reagen Diluent 2 kit
11 Rafid HbSAg 3 set
12 Rafid HIV 3 set
133 Rafid Siphilis 3 set
14 Strip Urine 2 set
15 Eosin 1
16 Orthosis Leher / cervical collar UK.S,M,L @5 pcs
17 Torniquet 5 pcs
18 Spatel Tongue 5 pcs
19 Set Sterile Hecting 5 pcs
20 Regulator O2 10 pcs
21 Masker O2 NRBM 500 pcs
22 Masker O2 Dewasa 200 pcs
23 Masker O2 Anak 100 pcs
24 Selang Nasal Kanul O2 300 pcs
25 Gastrul 100 tab
26 L-Bio / Lacto B 100 sach
27 Tremenza 300 tab
28 Etanol 90 % 30 Liter

Dst...
TAMBAHAN LAINNYA jlh satuan / kemasan
1 CHKM (Chlo 2 botol
2 Setoject (ja 100 pcs
3 Carpule 100 pcs
4 Setoject 3 pcs
5 GUEDEL / 20 pcs
6 Kertas EKG 20 pcs
7 TKF 2 box

Antisera
Golonga
n Darah /
8 6 set
Reagen
Golonga
n Darah
Reagen
9 2 set
Rinse
Reagen
10 2 kit
Diluent
Rafid
11 3 set
HbSAg
Rafid
12 3 set
HIV
Rafid
133 3 set
Siphilis
Strip
14 2 set
Urine
15 Eosin 1
Orthosis
Leher /
cervical
16 @5 pcs
collar
UK.S,M,
L
Tornique
5 pcs
17 t
 Spatel
5 pcs
18 Tongue
Set
Steril
e 5 pcs
Hecti
19 ng
Regu
lator 10 pcs
20 O2
Mas
ker
O2 500 pcs
NRB
21 M

Mas
ker
O2 200 pcs
Dew
22 asa

Mas
ker
100 pcs
O2
23 Anak

Sela
ng
Nasa
300 pcs
l
Kanu
24
l O2
Gastr
25 ul 100 tab
L-
Bio /
Lact
26 oB 100 sach
Trem
27 enza 300 tab
Etan
ol 90
28 % 30 Liter

catatan untuk tambahan obat yang tidak tertera diatas

Kerjasamanya.
 MENGETAHUI, Tim Perencanaan Obat dan
KEPALA PUSKESMAS Tingkat Puskesmas

1. Ketua

H.M. Fakhrazi, S.Kep.,Ns 2. Sekretari

NIP.19690722 199002 1001

3. Anggota

a. Ruang B

b. Ruang Gi

c. Ruang L

d. Ruang K
tuan / kemasan
ang tidak tertera diatas bisa ditambahkan dikolom tambahan lainnya.
 Barabai, 23 November 2020

Tim Perencanaan Obat dan Perbekalan Kesehatan

Tingkat Puskesmas

: dr. Apollo Gurning

NIP. 196907222006041009

: Santi Ramadani,S.Farm., Apt

NIP. 198904252019032011

3. Anggota

: Sarnani, AMK
NIP. 197804212005011010

: drg. Bambang Joelistio

NIP. 196307071992031012

: Meilda Hidayati, Amd., AK

: Mahreeta, S.ST
NIP. 19770115 200903 2002
 Halaman 12

RENCANA KEBUTUHAN OBAT DAN PERBEKALAN KESEHATAN TAHUN 2021

PUSKESMAS : BIRAYANG
KABUPATEN / KOTA : HULU SUNGAI TENGAH

Pemakaian
Rata-Rata
Per Bulan
JUMLAH
SISA STOCK
(Jumlah Pemakain KEBUTUHA
NO. NAMA OBAT SATUAN HARGA 30 Agustus TOTAL HARGA KETERANGAN
Jan-Agustus 2020 N (18
2020
tidak termasuk jumlah BULAN)
obat yang ed dibagi 8)

1 2 3 4 5 6 8 9
47 Diazepam injeksi 5 mg/ml - 2 ml AMPUL 1,913 1 4 24 38,260
64 Fenobarbital injeksi 50 mg/ml - 2 ml AMPUL 2,265 - - 6 11,325
69 Fenol gliseron tetes telinga 10 % BTL 2,764 5 35 120 276,400
77 Gentian violet larutan 1 % BTL 2,999.7 3 31 18 44,996
79 Glibenklamida tablet TAB 137.00 10 450 240 27,400
80 GUAIFENESIN 100 MG TABLET TAB 147.99 75 607 1,800 221,985
83 Glukosa larutan infus 40 % steril @ 25 ML BTL 8,999.98 - - 12 90,000
87 Haloperidol tablet 1,5 mg TAB 59 113 735 2,400 118,000
123 Kertas ECG uk. 80 MM X 20 M ROL 96,150 - - 4 288,450
125 KACAMATA GOGGLE SEKAR GUNA M PCS 200,000 - - 6 1,000,000
129 LODECON TABLET TAB 480.37 1 490 6,000 2,401,850
130 LODECON FORTE TABLET TAB 607.42 61 950 1,200 607,420
136 L-BIO BKS 6,930 - - 120 693,000
152 MEYLON 8,4% @ 25 ML BTL 6,448 0 2 2 12,896
153 Natrium klorida larutan infus 0,9 % steril BTL 6,840 18 87 840 4,788,000
160 Obat batuk hitam ( O B H ) cairan BTL 10,725 0 48 60 536,250
163 Oksitetrasiklina hcl salep mata 1 % TUBE 2,774 7 59 120 277,400
164 Oksitosina injeksi 10 iu/ml - 1 ml AMPUL 1,232 46 481 18 18,480
183 Rapid Test Covid Igg-Igm Lungene PCS 167,200 - - 30 4,180,000
185 Retinol ( Vit A )tablet salut 200.000 IU TAB 637.0 222 - 12 6,370
193 Salisil Bedak 2 % KTK 1,066.000 7 5 156 138,580
206 Sulfasetamida tetes mata 15 % BTL 8,800 1 - 6 44,000
208 Tablet Tambah Darah Kombinasi TAB 409 273 2,110 8,400 2,863,000
210 THERMOMETER FORHEAD OMRON PCS 419,950 - - 2 839,900
216 Trikresol formalin (tkf) cairan BTL 80,800 - - 2 161,600
217 Vaksin rabies Vero KUUR 139,150 1 - 10 1,113,200
219 Yodium Povidon larutan 10 % 300 ml BTL 21,600 1 7 12 216,000
220 Yodium Povidon larutan 10 % 30 ml BTL 3,840 0 9 12 38,400
222 AUTOCLICK (Lancet devide) SET 20,028.42 - 1 5 80,114
228 ALPRAZOLAM TAB 1 mg TAB 120 24 18 600 60,000
230 AMBROXOL SIRUP BTL 6,270 1 149 600 3,135,000
231 AMBROXOL TABLET TAB 313.5 99 1,366 12,000 3,135,000
239 ANTRAIN/NORAGES INJEKSI/METAMIZOLE INJ AMPUL 8,266.5 33 149 1,200 8,266,500
240 APD COVERALL SUIT BOHO PCS 1 - - 12 10
242 ARSUAMOON TABLET (DHP/ANTI MALAR) KTK 19,206 - - 12 192,060
254 ASEPTAN ANTISEPTIK BOTOL 30,475 3 5 72 1,828,500
255 ASICLOVIR SALEP TUBE 3,465 3 4 120 346,500
260 AZITROMISIN 500 MG TAB KAP 4,613 - - 360 1,383,900
261 BAHAN TAMBAL GIGI CAVITON (CAVIT W DAN P KOTAK 245,000 0 2 1 245,000
265 BECEFORT KAPLET TAB 1,826.0 68 - 1,800 2,739,000
266 BIOLYSIN SYRUP BTL 11,495 10 - 1,200 11,495,000
268 BEROTEC 0.1% LARUTAN 50 ML BTL 130,190 0 - 6 650,950
269 BETAHISTIN TABLET 6 MG TAB 119 100 700 2,400 238,000
271 NEUROBION INJEKSI AMPUL 3,190 - - 360 957,000
272 BENEORON TABLET (BIORON) TAB 711.5 - - 3,000 1,778,750
274 BABY COUGH SIRUP BTL 4,500 - - 36 135,000
276 BISOPROLOL 5 MG TABLET TAB 399 - - 120 39,900
277 BISTURI NO 15 (aesculap 15) PCS 3,069 10 - 240 613,800
291 CEFIXIM 100 KAPS TAB 2,430 - - 1,200 2,430,000
292 CEFIXIM SYR BTL 9,400 - - 24 188,000
293 CEFOTAXIM 1 g INJEKSI VIAL 4,706 36 95 840 3,294,200
295 CEFTRIAXON INJEKSI VIAL 5,146.0 10 20 240 1,029,200
298 CENDO XITROL BTL 27,500 - - 12 275,000
299 CEPADROXYL KAPSUL KAP 650.000 94 1,100 12,000 6,500,000
300 CEPADROXYL SYR 125MG/5 ML BTL 4,360 2 1 60 218,000
301 CETIRIZIN SYRUP BTL 3,061 10 - 600 1,530,500
302 CETIRIZIN TABLET TAB 104 157 100 18,000 1,560,000
309 CLOBETAZOL KRIM 0,05%(LOTASBAT KRIM) TUBE 66,000 0 - 6 330,000
311 CROFED TAB 1,430 - - 360 429,000
319 CURCUMA (SARI TEMULAWAK) TAB 876.15 112 736 4,800 3,504,600
322 D5% 1/4NS BTL 9,350 1 - 24 187,000
337 EKG 6 CM UNTUK MESIN ECG ROLL 193,600 0 - 6 968,000
346 FDC I PAKET 477,791 2 5 1 477,791
353 FRESH CARE( MINYAK ANGIN) BTL 15,700 - - 18 235,500
354 FLUOSINOLON cream SYNARCIS TUBE 2,660 2 10 12 26,600
362 GLUCOSAMINE 500 MG KAPLET 3,402.7 - - 360 1,020,810
363 GELAS UKUR 100 ML PCS 116,600 - - 1 116,600
367 GENTAMICIN SALEP KULIT TUBE 1,980 1 - 240 396,000
371 GLIMEPIRIDE 2 MG TAB 207 93 225 1,800 310,500
376 H2O2 3% BTL 4,032 0 5 2 8,064
379 HANDSCOON NON STERIL ukuran M,KPP PCS 935.00 349 - 18,000 14,025,000
380 HEMAFORT TABLET TAB 853.88 39 - 3,600 2,561,640
 Halaman 13

Pemakaian
Rata-Rata
Per Bulan
JUMLAH
SISA STOCK
(Jumlah Pemakain KEBUTUHA
NO. NAMA OBAT SATUAN HARGA 30 Agustus TOTAL HARGA KETERANGAN
Jan-Agustus 2020 N (18
2020
tidak termasuk jumlah BULAN)
obat yang ed dibagi 8)

1 2 3 4 5 6 8 9
386 HYSCOPAN/ SCOPMA TABLET TAB 330 - - 360 99,000
392 IHTIOL SALEP TAB 5,500 - 24 6 27,500
393 ILIADIN DROP 0.025% TTS HIDUNG ANAK BTL 37,433 2 - 6 187,165
395 ILIADIN SPRAY 0.050% TTS HIDUNG DEWASA BTL 39,468 1 - 24 789,360
399 KA. DIKLOFENAK 50 MG TAB 770 - - 2,400 1,540,000
400 KALNEX KAPSUL/ ASAM TRANEKSAMAT TAB 1,784 65 - 840 1,248,800
407 KETOKONAZOL 2% CREAM TUBE 2,577 9 48 120 257,700
408 KETOKONAZOL TAB TAB 305 1 80 120 30,500
409 KETOPROPEN 100 TAB TAB 553 - - 60 27,636
411 KETOROLAC 30 MG/1 ML INJ AMPUL 1,045.00 - - 6 5,225
415 KOMPOLAX SYRUP 60ML BTL 5,687 3 6 90 426,525
419 LANZOPRAZOL TAB TAB 330 3 - 1,200 330,000
427 MASKER N95 PCS 65,000.0 11 80 240 13,000,000
428 MASKER BEDAH (VICA CHECK), MMP,KPP,SST PCS 3,204.828 195 - 48,000 128,193,120
430 MB DEWASA BLISTER 36,579 0 6 1 36,579
432 MELOKSIKAM 15 MG TAB TAB 1,366.86 72 - 3,600 4,100,580
433 MELOXICAM 7,5 MG TAB TAB 788.766 151 90 9,600 6,310,128
434 MINDRAY M-30 CFL LYSE 500 ML BOTOL 1,996,500 - - 2 3,993,000
436 MINDRAY M-30 PROBE CLEANSER 17 BOTOL 332,750 - - 2 665,500
437 METFORMIN 500 MG TABLET TAB 109 209 60 24,000 2,180,000
438 MORTIR NO.16 PCS 100,100 0 - 2 200,200
440 MASKER KN 95 PCS 71,250 - - 24 1,425,000
452 MINI ASPI 80 MG TABLET 105.00 33.7777777777778 225 1,200 105,000
454 MINDRAY RINSE M30 20L GALON 1,730,300 - - 2 3,460,600
463 NASAL CANULA ADULT SET 6,325 2 11 30 158,125
467 NISTATIN DROP (KANDISTATIN DROP) BOTOL 45,100 - - 84 3,157,000
470 NOZA TAB TAB 935.0 79 - 600 467,500
473 OXYGEN MASK CHILD SET 15,584.8 0 15 14 187,018
478 ONDANSETRON 8 MG TAB TAB 404 44 - 720 242,400
479 OXYGEN MASK ADULT SET 15,584.8 0 9 6 77,924
480 PANTOCAIN TTM 0,5 % BTL 11,500 - - 12 115,000
484 RAPID TEST COVID 19 WONDFO PROVINSI PCS 1 - - 30 25
508 PLASTIK KLIP OBAT KECIL (10CMX7CM) BKS 3,600 0 23 4 10,800
509 PLASTIK KLIP OBAT TANGGUNG (12CMX8CM) BKS 4,800 1 18 12 48,000
514 RANITIDIN INJEKSI 25 mg/ml AMPUL 1,155 44 - 2,400 2,310,000
526 ROLL PAPER ELECTROCARDIO 8 CM ECG -300 ROL 92,560 0 1 6 462,800
528 RECO TETES MATA (KLORAMFENIKOL) BTL 8,250.0 1 21 180 1,237,500
529 RECO TETES TELINGA (KLORAMFENIKOL 1%) BTL 8,250.0 1 25 180 1,237,500
541 REAGEN XYLOL BTL 23,100 0 - 6 115,500
542 RETINOL ( Vit A )tablet salut 100.000 IU TAB 356 39 - 120 35,600
548 STIMUNO FORTE TABLET TAB 2,351.25 1,232 - 600 1,175,625
549 SCABIMITE ( Permethrin 5%) TUBE 11,825 0 16 60 591,250
565 SOLAFLUZ SIRUP BTL 15,246 - 20 240 3,049,200
566 SANGOBION DROP BOTOL 37,290 - - 6 186,450
569 STESOLID RECTAL TUBE 10 MG TUBE 21,021 1 5 12 210,210
570 STESOLID RECTAL TUBE 5 MG TUBE 14,459 0 5 12 144,590
573 SELKOM-C TAB 1,347.50 321 - 18,000 20,212,500
575 SOLVITRAL TABLET 563.86 634 310 18,000 8,457,900
582 STIK KOLESTEROL BENECHEK KOTAK 256,122 8 - 120 25,612,200
584 SARUNG TANGAN NON STERIL UK.L PCS 935 - - 120 93,500
585 STOMAG TUBE NO 12 SET 4,081 - 12 4 12,243
599 TERMOHIGROMETER SET 353,100 - - 1 353,100
600 TERBUTALIN (BRICASMA) RESPULES PCS 7,124 2 - 18 106,860
610 PHARMAFIX 10 CM X 10 M PCS 77,039.6 - - 6 385,198
612 VAR ( Vaksin Anti Rabies ) AMP 165,000 1 8 19 2,640,000
613 VENTOLIN NEBULIZER BTL 4,000 - - 60 200,000
624 ASAM TRANEKSAMAT INJ AMP 2,225 4 10 12 22,250
625 AESCULAP NO.20 PCS 3,069 - 100 120 306,900
626 BAYI OXYFLOW PCS 6,325 0 9 6 31,625
627 D 1/4 NS INFUS BOTOL 10,624 2 - 24 212,480
628 KA-EN 3B INFUS BTL 10,050 1 - 6 50,250
629 SUKRALFATE SUSPENSI BOTOL 7,338 - - 600 3,669,000
633 MY JELLY KOTAK 33,982.3 1 5 4 101,947
634 ONDANSETRON 4 MG TAB TAB 429 120.222222222222 313 2,400 858,000
636 METRONIDAZOLE OVULA/ VAGISOL OVULA 3,590 3.44444444444444 (1) 36 107,700
640 ALAT LABORATORIUM BENECHEK BUAH 222,682 - - 2 445,364
641 KLORAMFENIKOL 500 MG (CLORAMEX) KAP KAPSUL 1,338 22 - 60 66,900
661 BISTURI/ AESCULAP NO 10 PCS 3,300 9 100 120 330,000
663 ONDANSETRON HCL DIHYDRATE 4 MG INJ AMPUL 1,258 11 54 960 1,006,400
665 KACA SLIDE NO.7101 KOTAK 20,244.78 - 3 2 40,490
673 ULTRASONIC GEL 250 ML BOTOL 15,100.8 1 - 12 151,008
676 ZINC PRO DROPS 10MG BOTOL 6,281 4 5 84 439,670
677 PHYTOMENADION INJ 2 MG/ML AMPUL 4,236 23 66 96 338,880
688 ASAM FOLAT TABLET 0.4 MG(PROFOLAT) TABLET 64 12 215 240 12,800
691 PHENOBARBITAL INJ.50MG/ML-1ML AMPUL 2,265 2 10 6 11,325
700 SCOPMA PLUS KAPLET 1,155 1 - 600 577,500
701 THIAMEX (THIAMFENICOL 500 MG) KAPSUL 660 26 - 120 66,000
708 ARFEN TABLET 460.0 18 380 600 230,000
230,000
BATAS LAPORAN SEPTEMER 2020
 Halaman 14

Pemakaian
Rata-Rata
Per Bulan
JUMLAH
SISA STOCK
(Jumlah Pemakain KEBUTUHA
NO. NAMA OBAT SATUAN HARGA 30 Agustus TOTAL HARGA KETERANGAN
Jan-Agustus 2020 N (18
2020
tidak termasuk jumlah BULAN)
obat yang ed dibagi 8)

1 2 3 4 5 6 8 9

TAMBAHAN LAINNYA jlh satuan / kemasan

1 CHKM (Chlorofenol Champor menthol) 2 botol
2 Setoject (jarum) 100 pcs
3 Carpule 100 pcs
4 Setoject 3 pcs
5 GUEDEL / AIR WAY 20 pcs
6 Kertas EKG ukuran lebar 80 mm x 20 20 pcs
7 TKF 2 box
8 Antisera Golongan Darah / Reagen Golongan Darah 6 set
9 Reagen Rinse 2 set
10 Reagen Diluent 2 kit
11 Rafid HbSAg 3 set
12 Rafid HIV 3 set
133 Rafid Siphilis 3 set
14 Strip Urine 2 set
15 Eosin 1
16 Orthosis Leher / cervical collar UK.S,M,L @5 pcs
17 Torniquet 5 pcs
18 Spatel Tongue 5 pcs
19 Set Sterile Hecting 5 pcs
20 Regulator O2 10 pcs
21 Masker O2 NRBM 500 pcs
22 Masker O2 Dewasa 200 pcs
23 Masker O2 Anak 100 pcs
24 Selang Nasal Kanul O2 300 pcs
25 Gastrul 100 tab
26 L-Bio / Lacto B 100 sach
27 Tremenza 300 tab
28 Etanol 90 % 30 Liter

Dst...